The Assocation Of Hepatitis B Virus Genotype And Bascal Core Protmoer Mutations With Liver Cirrhosis And Hepatocellular Carcinoma Risks In Southern Shandong Province

Background & Aims:According to the report of WHO, there are about 2 billion people who have ever infected with hepatitis B virus (HBV), and among them 350 million are with chronic HBV infection. The duration of HBV infection and the degree of liver damage in chronic hepatitis are related to the risk of the hepatocellular carcinoma(HCC). The clinical outcome of the HBV infection are related to host (such as age, sex) and viral factors. In our country, the major HBV genotypes are genotype B and C. In north China, the major genotype is type C, while in south China, it is type B. Compared to patients infected with genotype B, those infected with genotype C develop to svere liver damage, such as liver cirrhosis and HCC, more frequently. HBV DNA viral load and HBV genotype C are independent risk factors of HCC development.HBV mutations might also play a role on the development of HCC. A high prevalence of the Bascal core promoter (BCP) mutation:A1762T/G1764A was observed among patients with liver cirrhosis and HCC. However, the prevalence of major HBV genotype and BCP mutation and their relationship with liver cirrhosis and HCC development in South area of Shandong Province are not clear. So, the aims of the study were to investigate the prevalence of HBV genotype and BCP mutation and their association with liver cirrhosis and HCC risk in patients of South Shandong. Method:111 patients with chronic HBV infection were studied(37 patients with chronic hepatitis B,37 with liver cirrhosis,37 with HCC). HBV DNA viral load, HBV genotype, and BCP mutation were detected with real time PCR, nucleic acid, and geno chip method, respectively. Chi-squre test were used to compare the prevalence of HBV genotype and BCP mutation among different patient group. T test were used to compare contionus variables. P value less than 0.05 was considered stasticaly significant.Results:Among the 37 patients with chronic hepatitis B, liver cirrhosis, and HCC, patients who have the negative HBeAg are 8(21.6%),28(75.7%), and 31 (83.8%); The rate of the HCC patients who have negative HBeAg are obviously higher than the CHB patients (P<0.05).The main genotype in both male and female is genotype C, which account for 57.3% and 54.5%, and there is no significant statistical difference in gender. There is no superiority of the genotype B and C in patients whose ages are below 30, while the genotype C dominates the patients who are older than 30 (P<0.05); Among the 37 patients with HCC and LC, the HBV are mainly genotype C, which accounts for 70.2% and 73.0%; while the CHB are mainly genotype B, which accounts for 67.6%.The rate of the BCP mutation in patients with HCC and LC are 64.9% and 56.7%, and in CHB is 27%. In the CHB patients, the genotype C has the bascal core promoter mutation more frequently, which makes up 65.6% (42/64).Conclusion:In the southern part of Shandong province, the main HBV genotype are genotype C and B. Patients with liver cirrhosis and hepatocellular carcinoma mainly infect genotype C. Patients with CHB, the genotype C is likely to have the BCP mutation. Patients with hepatocellular carcinoma have an obvious higher risk of infection of BCP mutation than those with CHB.